新乡地区同种抗体筛选及影响因素分析

Study on alloantibodies screening and its influencing factor in Xinxiang area

目的发现有临床意义的不规则抗体,建立稀有血型库,为患者提供抗原相同的血液,降低不规则抗体的产生,减少或避免同种抗体引起输血反应和新生儿溶血病。方法采用凝集胺、抗球蛋白、菠萝酶等方法,利用抗原抗体特异性反应的原理,对随机无偿献血者6000例和医院随机患者4100例做同种抗体筛选比较。结果检出同种抗体56例(0.55%),女性(38/3690例,1.02%)产生同种抗体比例高于男性(18/6410例,0.28%,P<0.001),产生同种抗体者多有输血史或妊娠史(41/56例,73.2%),Rh抗体(26/56例,46.4%)为多见。结论随机混合O型红细胞做筛选时可能漏检个别抗体,酶法、凝聚胺法和抗球蛋白法体均可能有假阴性或假阳性,对重危患者输血前试验宜结合病史并采用几种方法做抗体筛选。

Objective To find significantly clinical irregular antibodies, establish rare blood type bank, and provide patients with blood characterized with the same antigen, in order to decrease production of irregular antibodies, decrease and avoid transfusion reaction and hemolytic disease of the newborn caused by alloantibodies. Methods According to the principle of antigen and antibody specific reactions, screening and comparison randomly of alloantibodies wrere performed in 6000 cases of blood donation without repayment and 4100 in-hospital patients by polybrene,antiglobulin and bromelin methods. Results Fifty-six （55.5 % ） samples of alloantibodies were detected. The incidence of alloantibodies in female （38/3690 cases, 1.02 % ） was higher than that in male （18/6410 cases, 0.28%, P〈 0. 001 ）. Alloantibodies occurred in those who suffered from history of transfusion or pregnancy （41/56 cases, 73.2%）,Rh antibody （26/56 cases, 46.4%） was common. Conclusion The randomly mixed red blood cell screening may cause missing detection of some antibodies, and the methods of polybene , antiglobulin and bromelin can result in false negative or false positive. It is reasonable that the test before transfusion combined history and using some methods for antibodies for screening in severe and risk patients.